I am a plastic surgeon in Little Rock, AR. I used to "suture for a living", I continue "to live to sew". These days most of my sewing is piecing quilts. I love the patterns and interplay of the fabric color. I would like to explore writing about medical/surgical topics as well as sewing/quilting topics. I will do my best to make sure both are represented accurately as I share with both colleagues and the general public.

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Thursday, October 7, 2010

It’s been almost a month since the LA Times ran the article by Chris Woolston: The Healthy Skeptic: Stem cell face-lifts on unproven ground. It’s well written and presents a fairly balanced view. While I am a fan of stem cell research, I think the “claims” are often put ahead of the science. This is one of those times. I can’t find any decent articles to support the claims of the plastic surgeons doing “stem cell face-lifts.”

My view is echoed in the article (bold emphasis is mine):

Rubin says he's excited about the potential of stem cells in the cosmetic field and beyond. Still, he adds, there are many unanswered questions about the cosmetic use of stem cells, and anyone who claims to have already mastered the technique is jumping the gun. As Rubin puts it, "Claims are being made that are not supported by the evidence."

While researchers in Asia, Italy, Israel and elsewhere are reporting decent cosmetic results with injections of stem cell-enriched fat, Rubin says that nobody really knows how the stem cells themselves are behaving. He points out that fat injections alone can improve a person's appearance, no stem cells needed.

Rubin believes it's possible that injected stem cells could create new collagen and blood vessels — as they have been shown to do in animals studies — but such results have never been proved in humans. And, he adds, the long-term effects of the procedures are an open question.

Stem cell face-lifts could someday offer real advances, says Dr. Michael McGuire, president of the American Society of Plastic Surgeons and a clinical associate professor of surgery at UCLA. But he believes that scientists are still at least 10 years away from reliably harnessing stem cells to create new collagen and younger-looking skin. Until then, promises of a quick stem cell face-lift are a "scam," he says.

“Procedures with no solid science behind them, stem cells included, give unproven hope to patients and the marketing of them brings dishonor to our entire specialty,” said Felmont Eaves, III, MD of Charlotte, NC, President of ASAPS. The Aesthetic Society is working together with the other core societies to address this through an evidence based medicine program that will rate any procedure or device on the legitimacy of the scientific evidence behind it. This program is in its development stage and will be available to the public within the next 12 months”.

“The use of ‘stem cells’ in advertising for cosmetic surgical applications is a global problem," says Doug Sipp, Head of the Science Policy and Ethics Study Unit at the Center for Developmental Biology of RIKEN in Kobe, Japan, who monitors supposed stem cell treatment claims worldwide in all different specialties. "There have been many cosmetics, nutraceuticals, and device makers who claim either to use stem cells in their products, or to use ingredients that activate the customer’s own stem cells. To the best of my knowledge, none of these has a basis in scientific evidence."

Marketing. That seems to be the issue here. And there is much money to be made in promises that may or may not be kept with the use of stem cells. From the LA Times article:

Stem cell face-lifts: A Sept. 13 Health section story assessing stem cell face-lifts offered by two Beverly Hills doctors said that Dr. Nathan Newman charges between $5,500 and $9,500 for the procedure and Dr. Richard Ellenbogen charges $15,000 to $25,000. The story should have noted that Ellenbogen often performs a surgical face-lift along with his injection of stem cells. —

2 comments:

Dr. Singer, ex-ASAPS president, spoke about the marketing of Stem-cell facelifts at the recent Toronto meeting. Based on FDA regulations regarding stem cells, there is actually regulatory language that states these uses may not be promoted commercially by practitioners . The legal argument is complex, but essentially fat augmented with stem cells constitutes a "biologic product", which requires regulatory oversight and FDA review, and is classified along with prescription drugs.

Additionally, since the benefit of a "stem cell facelift" is completely unproven, it's ethically questionable to promote it.

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